Intergenerational continuities in ethnic inequalities in
health in the UK

Abstract

Previous research strongly suggests that ethnic minorities are more likely to suffer a poorer
health profile compared to the overall population. Trends have emerged to suggest that social
factors such as socioeconomic status and health behaviours are not fixed across generations
and have a role to play in these inequalities in health. This thesis investigated the differences in
ethnic inequalities in health between the first and second generations, and determined the
extent to which intergenerational changes in socioeconomic status and health behavioural
factors might explain any variation that exists.
The study used ethnically‐boosted data from the third sweep of the Millennium Cohort Study
(n=14,860) and the combined 1999 and 2004 Health Survey for England (n=28,628). Crosssectional
analysis investigated generational differences in self rated general health, limiting
illness, obesity, hypertension, depression, psychological distress and a range of biomarkers of
cardiovascular disease, across the major ethnic minority groups in the UK (Indian, Pakistani,
Bangladeshi, Black Caribbean, Black African, Irish, Chinese and Other). Children were
additionally assessed for levels of cognitive development using the British Abilities Scales II. The
generational change in socioeconomic circumstances (social class, highest educational
qualification and household income) and the extent of acculturation (current smoking and
drinking status, dietary behaviours and patterns of breastfeeding, immunisations and physical
exercise) was examined.
Strong upward intergenerational socioeconomic mobility in ethnic minority groups did not lead
to improving health profiles. The second generation required greater levels of social advantage
than the first generation to achieve the same level of health. Acculturative shifts led to a
worsening in health behaviours, although the degree of change was highly ethnic group specific.
Findings showed that the social and economic contexts, and the cultural identities and
behaviours of ethnic minorities, differ across generations, but ultimately their opposing
influences on health result in stable overall patterns of health inequality across generations.

Type:

Thesis
(Doctoral)

Title:

Intergenerational continuities in ethnic inequalities in
health in the UK